Colon perforation during percutaneous renal surgery: a 10-year experience in a single endourology centre

Kachrilas, Stefanos; Papatsoris, Athanasios; Bach, Christian; Kontos, Stylianos; Zaman, Faruquz; Goyal, Anuj; Masood, Junaid; Buchholz, Noor

doi:10.1007/s00240-012-0464-4

Cited by 15 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The possible reason for this higher transfusion rate could be a lower baseline haemoglobin level and consequently a lower reserve and threshold for transfusion. One of the most devastating complications of PCNL is injury to surrounding organs, most commonly large bowel injury [23] .…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of outcome of percutaneous nephrolithotomy using the ‘STONE’ nephrolithometry score: A single-centre experience

Farhan

Nazim

Salam

et al. 2015

Arab Journal of Urology

View full text Add to dashboard Cite

ObjectiveTo assess the prediction of stone clearance and complications of percutaneous nephrolithotomy (PCNL) using the ‘STONE’ nephrolithometry score, assessing stone size, tract length (skin-to-stone distance), degree of obstruction, number of calyces involved and stone essence (density).Patients and methodsThis was a prospective study of patients undergoing single-tract PCNL while prone, conducted at a university hospital. All patients had non-contrast-enhanced computed tomography within 3 weeks of the procedure. Only patients with a unilateral procedure and radio-opaque stones were included. The five variables of the STONE nephrolithometry score were calculated before the procedure. The stone-free rates were assessed with a plain abdominal film at 4 weeks and complications were graded using the modified Clavien system.ResultsIn all, 107 patients were included in the final analysis. Overall, 80% of patients were rendered stone-free. Among the individual variables, a larger stone (P = 0.002) and the involvement of multiple calyces (P = 0.04) were associated with residual stones, while tract length (skin-to-stone distance), stone density and presence of hydronephrosis were not. Patients who were rendered stone-free had a statistically significant lower overall STONE score than those with residual stones, at 7.24 vs. 8.14 (P = 0.02). The score also correlated with operative duration, which was significantly longer with a higher STONE score (P = 0.03). The complication rate was 18% and most complications were Clavien grade 2, with bleeding requiring a blood transfusion (11 patients) being the commonest. There were no deaths within 30 days of surgery, but there was no correlation between the STONE score and complications.ConclusionThe STONE nephrolithometry score is a simple and easy to apply system for predicting complexity in stone clearance with PCNL.

show abstract

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of outcome of percutaneous nephrolithotomy using the ‘STONE’ nephrolithometry score: A single-centre experience

Farhan

Nazim

Salam

et al. 2015

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…As there is no single surgical procedure without possible complications, the ones with the least complications will generally gain acceptance. Since the introduction of percutaneous renal surgery forty years ago, the continuous evolvement of the procedure is taken place through miniaturizing the standard size of 24-30 Fr to the mini and ultra-mini one [11][12][13] Fr to minimize the renal tissue damage, the replacement of fluoroscopy by ultrasound to access the pelvicalyceal system to minimize the hazard of radiation exposure to the patient and operating personnel and the patient positioning during the procedure from prone to supine or oblique to ease the patient position for less anesthetic complications, to shorten the operation time and to decrease the chance of colonic injury as the colon changes its relation to the kidney with patient position 13,14 . Despite the invasiveness of the PCNL procedure the colonic injury is a rare (0.2%) but it is a serious one and every effort should be made to avoid colonic injury.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the computerized abdominal tomography (CT) scan, retrorenal colon is usually found in 0.9% to 16.1% of the general population. This normal variation is higher in females, in the prone compared to the supine position, in the left rather than the right side, and higher to the lower than upper poles 3 , [9][10][11] . The increasing use of multiphasic CT scanners has made it the main imaging preference in the diagnosis of renal stones (including the radiolucent ones) and to determine the stone location within the kidney and thus enables the most suitable track selection and the relationship of the kidney to the surrounding structures, and unsuspected retrorenal colon, so it will alert the endo-urologist to such anatomic colonic variant and helps in the planning of an approach that will avoid a potentially serious colonic complication 5,12 .…”

mentioning

confidence: 85%

The Prevalence of Retrorenal Colon Among Computerized Tomography Scanned Patients

Abdulkareem

Musalah

Omar

2021

dmj

View full text Add to dashboard Cite

Background: percutaneous nephrolithotomy (PCNL) is regarded as the treatment of choice for most renal stones larger than 2cm. Colon injury is one of the rare and preventable complications during PCNL. The rare and unusual location of the colon behind the kidney (retrorenal colon) is an anatomical predisposing factor and other factors that can result in colon perforation during PCNL. Aim: To evaluate the prevalence of retrorenal and posterolateral colon and among CT scanned patients.Patients and methods: one thousand CT scanned patients of all ages and both sexes were included and their CT images were evaluated prospectively at the CT scan center at Azadi Teaching Hospital for the presence of retrorenal colon and the relation of the colon to different parts of the kidney. Results: In this study, 1000 CT scanned patients of different ages and both sexes were included. There were 522 males and 478 females; their ages ranged from 6 to 85 years. The overall prevalence of retrorenal colon was 7.5% (6.3% in males and 8.7% in females). The prevalence of retro renal colon according to different ages was: at below 10 y was 16%, 11-20 years 8.3%, 21-30 y 5.9 %, 31-40 y 7.2 %, 41-50y 7.2%, 51-60y 11.2%, 61-70y 5.8% 71-80y 7.2% and at 81-90 y was 9%, and the differences regarding the ages and sexes were statistically not significant. The lower pole of the left kidney is the most common part involved by the retrorenal colon in 70.6%, while the right lowers pole by 12%, the left middle part by 10.6%, and bilateral lower poles by 6.6%. Conclusion: Locally, the prevalence of retrorenal colon is within the usual range with no sex or age predominance, and a pre-operative abdominal CT scan (native one) is a diagnostic one and is essential if left lower renal calyx is planned to be targeted to avoid colonic injury.

show abstract

“…Most often these injuries are colonic and are managed conservatively provided the injury is retroperitoneal and no signs of peritonitis are present [3]. Being intraperitoneal, the small bowel is located at a distance from the kidney, and therefore the risk of its injury during PNL is extremely low.…”

Section: Discussionmentioning

confidence: 99%

Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy

Gadzhiev

Gorelov

Смирнов

et al. 2018

Case Reports in Urology

View full text Add to dashboard Cite

Background. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57-year-old patient with the 15 mm right pelvic kidney stone underwent uneventful SWL. Patient visited emergency department 3 days later with high fever and chills with severe right flank pain. CT urography revealed lower pole kidney injury with signs of infected hematoma due to low attenuation areas but without signs of obstruction or urine leakage. Infected haematoma was drained percutaneously under ultrasound and X-ray control and a pigtail catheter 10 Fr was left beneath the lower pole of the right kidney. Postoperatively duodenal injury was suspected due to amber color, low creatinine, and high bilirubin level in the drainage output. CT demonstrated that the pigtail of the drain had entered the second part of the duodenum. Catheter was withdrawn and defect of the duodenal wall was stapled with four staples endoscopically. After 2 days of fasting patient was allowed to start oral food intake and was discharged on the 5th day. Conclusion. Injury of the duodenum during percutaneous kidney manipulation is an extremely rare complication. Conservative management consisting of endoscopic stapling of the duodenal wall defect is a safe and feasible approach to expediting the recovery of the patient.

show abstract

Colon perforation during percutaneous renal surgery: a 10-year experience in a single endourology centre

Cited by 15 publications

References 22 publications

Prospective evaluation of outcome of percutaneous nephrolithotomy using the ‘STONE’ nephrolithometry score: A single-centre experience

Prospective evaluation of outcome of percutaneous nephrolithotomy using the ‘STONE’ nephrolithometry score: A single-centre experience

The Prevalence of Retrorenal Colon Among Computerized Tomography Scanned Patients

Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy

Contact Info

Product

Resources

About